Individual provider Active NPI

Grace E Knowles, CPNP

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1801275144
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209.18828 Issued in IL
Practice address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone
(800) 543-7362
NPI assigned
May 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hospice and Palliative Medicine Physician 2080H0002X C145682 IA
Pediatric Nurse Practitioner 363LP0200X CNP-02374 NM
Pediatric Nurse Practitioner 363LP0200X C145682 IA
Pediatric Nurse Practitioner 363LP0200X 209.18828 IL Primary

Addresses

Primary practice location

225 E Chicago Ave
Chicago, IL 60611-2991

Mailing address

1507 Oak Lake Park Rd
Coralville, IA 52241-1094
Phone (505) 250-4854

Other practice location 1

200 Hawkins Dr
Department of pediatric pallative care
Iowa City, IA 52242-1009
Phone (319) 546-4107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190530001167 IL Practitioner - Nurse Practitioner 2365757853 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.18828ILMDPediatric Nurse Practitioner
CNP-02374NMMDPediatric Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1801275144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 OAK LAKE PARK RD",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411094",
            "telephone_number": "505-250-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "800-543-7362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_2": "Department of pediatric pallative care",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-546-4107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "GRACE",
        "middle_name": "E",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "IA",
            "license": "C145682",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NM",
            "license": "CNP-02374",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C145682",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209.18828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.